• 제목/요약/키워드: ST25.ST36

검색결과 270건 처리시간 0.031초

연부 조직 육종의 수술 후 방사선 치료 결과 (Postoperative Radiation Therapy in the Soft-tissue Sarcoma)

  • 김연실;장홍석;윤세철;유미령;계철승;정수미;김훈교;강용구
    • Radiation Oncology Journal
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    • 제16권4호
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    • pp.485-495
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    • 1998
  • 목적 : 최근들어 연부 조직 육종의 치료방법이 광범위 구획절제에서 사지기능을 보존하는 제한적 수술과 방사선/항암화학요법의 다병용치료로 변환되고 있으며 광범위 수술과 유사한 치료성적을 거두고 있다. 저자들은 수술후 방사선 치료를 시행한 연부 조직 육종 환자를 대상으로 치료 결과 및 실패 양상을 알아보고 관련된 예후 인자를 분석하여 수술 후 방사선치료의 역할을 알아보고자 하였다. 대상 및 방법 : 대상환자는 1983년부터 1994년까지 치료한 60명이었고 모두 추적관찰이 가능했으며 평균 추적기간은 50개월이었다. 원발병소는 상$\cdot$하지가 35례(58$\%$)로 가장 많았고 체간 12례(20$\%$), 두경부 7례(12$\%$)였으며 병리학적 유형에 따른 구분은 악성섬유구종 14례(23$\%$), 지방육종이 10례(17$\%$), 악성신경섬유종 7례(12$\%$) 등 이었다. 전체환자중 6례를 제외하고는 조직학적등급의 분석이 가능했고 grade I, II, III가 각각 27례(45$\%$), 3례(5$\%$), 24례(40$\%$)였다. 수술적 절제는 19례(32$\%$)에서 광범위절제, 36례(50$\%$)에서 변연절제, 5례(8$\%$)에서 국소절제를 시행하였다. 방사선치료선량은 28.8-80Gy였고 25례에서 방사선치료와 함께 항암화학 요법을 병용하였다. 결과 : 최종분석 시 실패 양상은 국소재발이 20례(25$\%$), 원격전이 7례(12$\%$), 국소재발과 원격전이를 동반한 경우가 14례(23$\%$)였다. 원격전이한 환자는 구제치료와 상관 없이 모두 사망하였고 국소재발한 환자중 5명이 구제치료에 성공하여 무병생존하였다. 전체환자의 2년 및 5년 국소제어률은 68.0$\%$와 48.7$\%$로 비교적 저조한 결과를 보였다. 국소제어을에 영향을 미친 예후인자는 조직학적 유형, AJCC 병기, 조직학적 등급, 수술의 범위, 수술절연 침범 유무 및 잔존종양 정도, 림프절 전이 유무(p<0.05)였다. 전체 환자의 5년 생존률과 5년 무병생존률은 각각 60.4$\%$, 36.6$\%$였고 평균 생존기간은 89개월이었다 단변량 분석에 의한 생존률에 영향을 미친 예후인자로는 조직학적 유형, AJCC 병기, 림프절 전이 유무, 조직학적 등급, 수술절연 침범 유무와 잔존 종양 정도 였다. 결론 : 결론적으로 본 연구 결과 연부 조직 육종에서 제한적 수술과 수술 후 방사선치료로 비록 저조한 국소제어률을 보였으나 사지 절단 혹은 광범위 구획절제와 비교시 유사한 생존률을 얻었다.

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간호기록지를 통해서 본 간호과정 적용효과에 관한 연구(간호전문대학을 중심으로) (A Study on Effects of Application of Nursing Process by Nursing Profess notes.(School of nursing))

  • 최상순;조희숙;백승남
    • 대한간호학회지
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    • 제11권2호
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    • pp.55-68
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    • 1981
  • The prime object of the study is to evaluate how much all the students of the Nursing Schools throughout the nation are in comprehension toward the application of nursing process to clinical experience as means of systematic solution of nursing problems. An effort has been made to find out the actual state whether they are in practice of clinical experience in accordance with application of nursing process, over the period of four weeks managing from December 1st to 28th, 1980 and centering on 36 nursing schools, and meanwhile and evaluation, employing the assessment tool used by Bertuccietal, has been made on the nursing process notes recorded by 200 senions out of 21 nursing schools where application of nursing process to clinical experience being in practice. The assessment tool is composed of 5 different criteria in view of patient nursing and authors made an attempt to find out the result of clinical experience on application students in accordance with 5 different scoring criteria and further evaluating all the findings thereof. The findings were disposed of accordance with practice duration and criteria of the specific sudents subject to this finding as to verify the scoring difference in significance and of which the results are as follows: 1) as of now, in 21 (58.2%) out of 36 nursing Schools nursing process in being appliced in clinical experience. 2) Schools that started the application of nursing process to clinical experience amount to - for more than 4 yrs -6 (28.6%) - for 2 to 3 yrs-11s(52.4%) - for 1 yr -4 (19.0%) 3) As for the response upon application of nursing process. To clinical etperience, the largest voice (61.9%) heard was that it is rather difficult beyond the lecturing thereof, to practically apply it outs patients and the second voice (19.1%) turned out to be that it is hard to put in practice owing to uninformed nurses of the process serving in the clinical field. 4) The response. Of the processors assigned to instruction as to the most difficult problem in criteria of nursing process, the largest voice (38.2%) centered on the problem assessment while the second voice (17.7%) on the indirect nursing activity and the objective data respectively and considered to be the easiest was the indirect nursing activity (11.7%). 5) In order for a satisfactory. application of nursing process to clinical experience hence-forth, it has been pointed out that sufficient number of nurses should be supplemented in clinical field (44.1%) and at the same time supplementory education (35.3%) centered around professors be necessary. 6) Of the criteria that record result of nursing process, a significant difference in comprehension of subjective and objective data has been revealed according to the degree of the practice duration of application to clinical experience. For instance, while although poor it may seen, only 74.9% in subjective data and 71.1% in objective data represent the student group in practice for more than 4 years and only 56.3% in subjective data and 66.8% in objective data represent the student group in practice for 2 to 3 years but they still surpass in comprehension over the student group in practice for 1 year attaning only 19.6% in subjective data and 16.8% in objective data (P < 0.005). 7) As for problem assessment, the student group who started application of nursing process for 4 years stand for 37,7% the group for 2 to 3 years started for 25.3% and the group for 1 year started for 5.4%, revealing no significant difference according to duration (P < 0.5) and as poor as to indicate only 22.8% on an overage is in comprehension. 8) On direct and indirect nursing activity, the student group of for more than 4 years in appling nursing process (representing 49.5% in direct nursing activity, 21.4% in indirect nursing activity). Know more about it than the student group of for 2 to 3 years (representing 36.3% in direct nursing activity, 20.8% in indirect nursing activity) but revealed no significant difference. (P < 0.5) 9) The student group applying nursing process for more than 4 years subjective data (74.9%) comprehend were more than objective data (71.1%) but shown no significant difference (P < 0.5). 10) However, the student group applying nursing process for 2 to 3 years comprehend objective data (66.8%) well ever subjective data (55.5%) indicating that 40.9% in average is in comprehension, thereby revealing a significant difference (P < 0.005). 11) On the other hand, the student group applying nursing process to clinical experience for 1 year had revealed themselves as poorly as to comprehend only 11.7% are an average of it, revealing no significant difference (P < 0.5). In consequence of the fore going, I the conductor of the present study, hereby suggest the following points: 1) Application of nursing process to clinical experience be practiced in all the Nursing Schools all over the nation at the earliest possible date in order that scientific nursing be prevailed (as of now only 58.0%), 2) In teaching nursing process, it is desirable to teach specific method of applying to practical clinical situations. 3) In order to meet the end of satisfactory application of nursing process to clinical experience, sufgecient nursing man power be sysplemented in clinical field and at the save time supplementary education by professors is necessary. 4) Sinces the students whose application duration of nursing process to clinical experience is longer comprehend more about it, it is reguired that the schools not yet in practice of the application be promptlyurged to follow. 5) Of the criteria recording nursing process, since it is comparatively hard to comprehend“assessment”and“Direct and indirect nursing activity”, a concentrated instruction is desirable. 6) The students whose duration of application of nursing process to clinical experience falls short of 1 years be put in a concentrated guidance program on individual criterion.

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중풍 후 중추성 통증환자에 대한 봉독약침의 임상효과 -단일맹검 무작위배정 환자 대조군 비교연구- (Efficacy of Bee-venom Acupuncture on Central Post Stroke Pain -Single-blind Randomized Controlled Trial-)

  • 곽자영;조승연;신애숙;이인환;김나희;김혜미;나병조;박성욱;정우상;문상관;박정미;고창남;조기호;김영석;배형섭
    • Journal of Acupuncture Research
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    • 제26권6호
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    • pp.205-214
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    • 2009
  • Objectives : This study was designed to evaluate objectively the efficacy of bee-venom acupuncture on Central post-stroke patients. Methods : After screening, 25 patients recruited with eligible criteria. Among them 1 dropped out in treatment group, 4 in control group. We applied bee-venom acupuncture 6 points of body($LI_{15}$, $GB_{21}$, $LI_{11}$, $GB_{31}$, $ST_{36}$, $GB_{39}$) 2 times a week for 3 weeks for treatment group, and normal saline for control group in the same way. After 3 weeks treatment and 2 weeks follow up we measured VAS, categorial rating scale as a pain assessment also MBI, Modified Rankin Scale as a stroke recovery. Results : 1. Treatment group showed significant difference in VAS, categorial rating scale after treatment and 2 weeks follow up, compared with baseline. The control group showed significant difference between baseline and after treatment But the 2 weeks follow up, there is no significant difference compared with baseline. Also there's no significant difference in categorial rating scale. 2. MBI showed significant difference in treatment group between baseline and after treatment, but the control group did not have any difference. There's no significant difference in Modified Rankin Scale for treatment group and control group. 3. There's no significant difference between control group and treatment group. This is because of the small sample size in the study, Thus it seems to reflect individual difference strongly. Conclusions : There are positive effect on CPSP patients in pain and stroke recovery treating with bee-venom acupuncture than control group.

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중환자실 간호사의 기초간호과학 지식의 필요성 분석 (A Study of Content Analysis on ICU(Intensive Care Unit) Nurses' Knowledge of Basic Nursing Sciences)

  • 변영순;최명애;김희승;박미정;서화숙;이경숙;최스미;홍해숙
    • Journal of Korean Biological Nursing Science
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    • 제4권1호
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    • pp.41-49
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    • 2002
  • The purpose of this study was to identify the knowledge contents of basic nursing sciences needed by nurses in the practices of the intensive care unit(ICU). To attain the goal of this study, the nurses working at 10 hospitals in the areas of Seoul and Kangwon Province were randomly selected. They were primarily interviewed, and the open question was secondarily put to them through the questionnaire. In the process of the 1st interview, the interviewees were asked of the question, "What is the knowledge of basic sciences such as anatomy, pathology, physiology. microbiology, pharmacology and the like thought to be lacking when you communicate with doctors in the ICU and when you carry out your nursing practices in it?" The contents of the interview were tape-recorded. The period of data collection ranged from May 1, 2001 to Sept 30. The interviews were conducted with total of 20 nurses. The open-end questionnaire was secondarily mailed to nurses. 113 questionnaires were returned. 100 questionnaires except 13 ones thought to be poorly completed in content were used for data analysis. Three coders classified data obtained from the interview and the questionnaire research into 5 detailed items relating to such as anatomical physiology, pathology, pharmacology. microbiology and basics of nursing. The three coders had experiences in nursing education of 18 years, 8 years and 6 years, respectively, and of them one coder was professor in basic nursing sciences. Data were statistically treated using frequency analysis and percentage by the SAS program. As a result, the following findings were obtained : It was found that the contents that ICU nurses responded were most needed in the field of Human structure and function were water and electrolytic balance(38%), blood and circulatory system(20%), changer in the patient's skin(12%), the arrangement of the human body(10%) and the endocrine system(10%), nervous system(6%), and assessment of the state of the patient's consciousness(4%). It was found that the contents that ICU nurses responded were most needed in the field of pathology were found to be the process of the progress of the disease(32%), symptoms of the disease(27%), prognosis of the disease(22%), followed by the injury-healing process, clinical pathological examination, and examination by radiation. It was found that the contents that nurses responded were most needed in the field of pharmacology were the effect of drug(25%), the side effect of drug(22%), the relationship between diseases and drug(20%), the relationship between disease-causing bacteria and drug(20%) and chemotherapy(2%). It was found that the contents that ICU nurses responded were most needed in the field of microbiology were the relationship between diseases and disease-causing bacteria(45%), Kinds and characteristics of disease-causing bacteria(18%), infection control(16%), application of the aseptic technique(12%), isolation(9%) and the like. It was found that the basic knowledge that ICU nurses responded were needed were the identification of the patient's current state(36%), understanding of the therapeutic process(22%), the operating principle of medical equipment and instrument(20%), medical terminology(9%), equipment and instrument management(7%), calculation of the dose of injection(2%) and the like.

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전문대학 간호과의 임상 실험 효율화를 위한 연구 (A Study on the Efficiency of Clinical Practice for Nursing Education in the Junior College of Nursing in Korea)

  • 이군자;김명순;양영희
    • 한국보건간호학회지
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    • 제3권2호
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    • pp.77-108
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    • 1989
  • The purpose of this study was to find out the present condition of clinical practice and to develop a scheme on the efficiency of clinical practice for nursing education in junior college of nursing in korea. This study was conducted by 2 sections. Ist section was to find out the present condition of clinical practice to 42 directors of nursing collegd and data were collected July 8 to September 30, 1988. 2nd section wat to develop a scheme on the efficiency of clinical practice for nursing education and subjects were nursing professors 258: and clinical nurses 223 in 42 junior nursing colleges their clinical settings in korea. So total subjects were 481. Data were collected july 8, 1988 to June 30, 1988 and were analysed to get the mean, standand deviation, frequency, percentage, t-test, x-test used by SPSS - pc. Major findings were as follows: 1. The present condition of clinical education in junior college of nursing in Korea. 1) 32 colleges (76.2%) were managed by a-yeas system. 2) 25 colleges (59.5%) were performed by individual practice for each subject. 3) 4 weeks interval between class education and clinical education was a major type among total colleges(36.6%, J5 colleges) 4) 30 colleges (71.4%) provided clinical education for all subjects that should be practiced. Nursing administration wes not practiced in 5 colleges (41.9%) among the remainder(12 colleges). The main cause that all practice subjects were not practiced was the lack or absence of suitable clinical settings(8 colleges. 66.7%) 5) 18 colleges (42.9%) responded that a clinical educator was, subject-charged professor. 6) 12 colleges (29.3%) responded that a clinical instructor was in charge of 6~10 students. 7) The evaluation ration ratio(professor to head nurse) by each evaluator was mostly 50% to 50 % and 60% to 40%, respectively 11 colleges(27.5%) The most common evaluation methods were evaluation by head nures, report, presence, conference (11 colleges, 27.5%) 8) The field carrier of professor was mostly 2 years (79 persons, 20.7%) and mean was 3.2 years. The education carrier of a professor was mostly over than 6 years (261 persons, 66.4%) and mean was 9.2 years. The charge hours per-week of a professor were mostly 16-18 hours (16 persons, 131.8%) 9) 34 colleges (82.9%) approved that clinical practice hour was class hour and 18 colleges (43.9 %) counted that 2 hours of clinical education equaled 1 hour of class education. 2. A study 'on the efficiency of clinical practice for nursing education. L) general characteristics of subjects were as follows: kung-sang province (145 persons, 30.5%), 30-34 years (190 persons, 39.8%), graduated degree (245 persons, 51.5%), 6-10 years of carrier (199 persons, 41.4%) were the majority. 2) suitable clinical setting was responded the systematic ward with responsible clinical educator by 210 persons(43.8%) The response by working field of subjects showed a significant difference (p< 0.01) 3) 259 subjects (54.0%) responded that the desirable qualfication of clinical instructor was 3-5 years of clinical experience with master degree or higher. 4) The mean score of desirable quality degree of clinical instructor was 3.43 professors, score (3.54) was significantly higher than clinical nurses' (3.28) (p<0.01) 412 subjects (86.0%) responded that the insufficient guality of instructor was improved by continuing to seek more new information in reference. 5) 196 subjects (41.4%) responded that desirable qualification of head nurse was more than 2 years of head position among 5 years of clinical experience. The response by working' field of subjects showed a significant difference (p<0.05) 6) The mean score of desirable quality degree of head nurse was 3.18 Clinical nurses' score(3.38) was significantly higher than professors' (3.01) (p<0.01) 419 subjects (87.8%) responded that the insufficient of head nurse was improved by continuing relationship with instructor and being responsible from planing of clinical education. 7) The mean score of performance level of the desirable clinical education guide incollege was 2.91 Professors' score (2.96) was significantly higher than clinical nurses' (2.84) (p<0.01) 340 subjects (71.1%) responded that the possible resolution for poor performance was the more specified syllabus of clinical education and the satisfiable orientation for students. 8) The mean score of performance level of the desirable clinical education guide in hospital was 3.03 9) 141 subjects (29.6%) responded that the desirable clinical evaluator was the group of professor, head nurse, staff nurse. Response by working field of subjects was a significant difference (p< 0.05) 10) The mean score of performance level of the evaluation content needed in clinical education was 3.50 Clinical nurses' score (3.56) was significantly higher than professors' (3.45) (p<0.01) 11) 433 subjects (90.2%) responded that6 desirable evaluation method for clinical education was the presence. 12) The mean score of performance level about how personal difference among clinical educators was minimized was 2.89 and response by working field of subjects was not significant. The cause of poor performance was too much workload at clinical settings and too many students st colleges by 386 subjects (81.1%).

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임산부의 산전관리와 산욕기 영양실태에 관한 연구 (Clinical Study on Prenatal care, and Dietary Intakes for Pregnant Women and new Mothers)

  • 차순향;박재순
    • Journal of Nutrition and Health
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    • 제9권4호
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    • pp.36-46
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    • 1976
  • This study was projected to provide basic data on prenatal care for future direction in maternity and child care, and also to investigate the diet of women during pregnancy and the period directly afterwards in order to offer to mothers appropriate advice for the improvement of nutritional standards. A clinical study on prenatal care was based on 1054 delivery cases. A nutritional survey was performed on 174 mothers admitted to the department of obstetrics at St. Mary's Hospital during the period of March, 1975 to February, 1976. The results obtained are summarized as follows; I. Clinical study on prenatal care 1) The age distribution showed 59.4% of the mothers were between the ages of 25 to 29 years old. 2) The gestational period was highest between the 37th and 40th gestational weeks. 33.7% of the mothers were primigravidae and 31.8% of them primiparae. 3) 41.3% of the mothers had not received prenatal care or had only received it once before. 4) Induced deliveries were 61.8% and spontantaneous deliveries 38.2%. 61.9% of the mothers had received prenatal care, while those without prenatal care accounted for 61.6% of the total induced deliveries. 5) Low birth weights were 7.7% and 5.0% of the mothers had received prenatal care, while 11.5% had no prenatal care. 6) There were 1.13% of still births, 0.32% of the mothers had prenatal care and the remainder did not have prenatal care. 7) Of those receiving prenatal care, 2.1% showed in the $0{\sim}3$ Apgar score group, 6.3% in the $4{\sim}6$ Apgar score group, and 91.6% in the $7{\sim}10$ Apgar score group. Among the non-prenatally cared for group 5.0% of the newborns were in the $0{\sim}3$ Apgar score group, 9.7% were in $4{\sim}6$ Apgar score group and 85.3% were in the $7{\sim}10$ Apgar score group. 8) Obstetrical complications were developed in 11.86% of the pregnant women when they were hospitalized. Among the group receiving the prenatal care 8.1% of the mothers had obstetrical complications. In the group without prenatal care 17.16% of the mothers had obstetrical complications. The most common obstetrical complication was malpresentation. 9) The first prenatal care was received between the 37th and 40th gestationl weeks. II. Food intake during pregnancy The following are the results from the questionnaires of the mothers concerning diets during pregnancy; 1) Main meals and snacks In 32.2% of the cases, their main meals during the diet amounted to more than was usually eaten at other times. In 67.8% of the cases, their main meals during the diet were the same as that usually eaten. In 22.4% of the cases, snacks during the diet amounted to more than usually eaten at other times. In 77.6% of the cases, snacks during the diet were the same as usually eaten. 2) Itemized list The mothers made a special effort to include certain items in their diets, the following is a breakdown of those items; a. egg, meat, fish 33.3% b. fruit, vegetables 32.2%. c. milk, fruit juice 18.4% d. cake, bread 2.9% e. nothing special 13.2% 3) Milk 44.8% of the mothers had at least one cup of milk everyday. 33.4% of the mothers had at least one cup of milk on occasion. 15.5% of the mothers did not have any milk. 4) Vitamins 39.7% of the mothers had vitamins everyday. 24.7% of the mothers had vitamins occasionally. 35.6% of the mothers did not have any vitamins. 5) Anemic symptoms 9.2% of the mothers very often had anemic symptoms during pregnancy. 39.1% of the mothers often had anemic symptoms during pregnancy. 51.7% of the mothers did not have anemic symptoms at all. 6) Taboos on food 23% of the mothers recognized 'taboos' on food during pregnancy 27% of the mothers displayed on uncertainty about the 'taboos' on food during pregnancy 50% of the mothers displayed indifference toward the taboos. III. Nutritional survey on the new mothers diet. 1) The diets for new mothers can be divided into four categories, such as general diet, low sodium diet, soft diet and liquid diet. 2) Cooked rice and seaweed soup were the main foods for the new mothers as has been the traditional diet for Korean mothers. 3) The average diet contained 1,783g. And the average consumption of the basic food groups per capita per day was 1,265g for cereals and grains, 456g for meats and legumes, 58g for fruits and vegetables, 0g for milk and fish and 4g for fats and oils. 4) In addition to the 1,783g of food in the main diet there was also 142.8g of food taken as snacks. 5) The average daily consumption of calories and nutrients was 2,697 Kcal and 123.4g for proteins, 44.9g for fats, 718.2mg for calcium, 14mg for iron, 2,101.4 I.U. for vitamin A, 0.43mg for thiamine, 1.02mg for riboflavin, 15.88mg for niacin, 5.26mg for ascorbic acid. When these figures are compared with the recommended allowances for new mothers in Korea, the calories and nutrients taken in were satisfactory. But the intake of minerals and vitamins was below the recommended allowance.

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일부 도시지역 주민의 약물 장기복용에 관한 사회의학적 연구 (A Study on the Long-Term Use of Drugs Among Some Urban Residents)

  • 유호상;송동빈;염용태;차철환
    • 농촌의학ㆍ지역보건
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    • 제12권1호
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    • pp.102-110
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    • 1987
  • One of the familiar medical facility that most people reach easily in Korea is the drug store. In Korea, it is possible to purchase all kinds of common drugs without physician's prescriptions, which caused some problems. In other words, such treatment without professional supervision has led to medical, social and economical problems. In view of the above, this study is aimed at revealing the actual status of long-term use of drugs in some urban residents. Long-term use of drugs is operationally defined as using certain drugs at least once a week for more than 3 months. This survey took the residents of Guro 6-Dong where was one of the target areas for Community Health Development Project managed by Korea University as a target population. A sample of 1,517 residents was selected by the multistage sampling method. The interview was conducted on September 21st and 22nd in 1985. The object of this study was to compare the result with that of the rural area which was obtained by the same method, tools and research team, prior to this study in 1984. The results were as follows; 1) The age-standardization of the study showed that 97 per 1,000 urban residents were actually on long-term drug use. The prevalance of long-term use is high in accordance with aging and low with education level. 2) Out of 1,000 urban samples the most popular item involved in the long-term drug use was antipyretic-analgesic-antiinflammatory drug (26), and next in order was vitamin (23), antibiotics (13), digestives (10) and antacids (7). In the rural samples as for compare, that was antipyretic-analgesic-antiinflammatory drug (100), antacids (36), digestives (23), adrenocortical hormones (12) etc. 3) With antipyrctic-analgesic-antiinflammatory drugs, 50% of the urban samples were taking for more than a year, whereas such were 82.7% of the rural samples. Using such a high percentage of antipyretic-analgesic-antiinflamatory drugs in the rural residents is probably due to the high prevalence rate of musculo-skeletal diseases. 4) The urban long-term drug users of antipyretic-analgesic-antiinflammatory drugs were influenced mostly by the mass media (43.6%), next in order was pharmacist (35.9%) and physician (10.3%). Comparing with the result from the rural areas the role of mass media was much more influencial in the urban areas. 60% of them consulted with pharmacists, 14.3% with physicians and 25.7% had no history of consultation in the urban samples. 5) Considering the incidence of knowing the possible side-effects of each drug, 28.2% of the urban residents had no recognition about side-effects prior to use antipyretic-analgesic-antiinflammatory drugs. In the rural residents, 29.67o had no knowledge about the side-effects before using the drug. 6) For the solution of the above problems, it is necessary to limit the advertisement of some drugs by the parmaceutical company. And therapeutic drugs which may bring on side effects in case of long-term use should not be sold at drug stores without physician's prescription.

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침치료 직 후 자가 설문지를 이용한 침반응(針感)과 부작용에 대한 단면적 연구 (Short Tenn Reactions to Acupuncture Treatment and Adverse Events Following Acupuncture in Korea a Cross-sectional Survey of Patient Reports)

  • 박성욱;정우상;문상관;고창남;조기호;김영석;배형섭;박정미
    • 대한한의학회지
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    • 제28권2호통권70호
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    • pp.66-79
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    • 2007
  • Objectives : To explore the type and frequency of short term reactions, de Qi associated with acupuncture treatment and to determine the incidence of adverse events following acupuncture in Korea. Subjects and methods : This study is a retrospective and cross-sectional survey of patient reports. 1095 subjects, 585 of out-patients of the Oriental Medicine of Stroke & Neurological Disorders Center, East-West NEO Medical Center of Kyunghee University and 510 of out-patients of the Department of Cardiovascular & Neurologic Diseases (Stoke Center), Hospital of Oriental Medicine, Kyunghee Medical Center, from June through November of 2006, who had acupuncture, gave informed consent and completed one survey form. On this form, patients were asked to report short term acupuncture reactions, de Qi, patient satisfaction measurement (using VAS), and adverse events relating to acupuncture treatment. The acupuncturists of this study are Korean Medicine Doctors (KMD) who had worked as practitioners for 3-30 years or more. Results : The average age of the 1095 subjects was 58 years old. Positive short term acupuncture reactions after treatment were reported by 878 (80.2%), negative short term acupuncture reactions by 75 (6.8%) and no reactions were reported by 142 (13.0%). The most common positive short term acupuncture reactions were feeling 'relaxed', 472 (43.1%), followed by feeling 'less pain' 90 (8.2%), 'energized' 16 ( 1.5%), 'tingling' 16 (1.5%), 'heat feeling or Cold feeling' 10 (0.9%), and others 274 (25.0%), respectively. Negative short term acupuncture reactions were feeling 'pain' 37 (3.4%), tiredness 24 (2.2%), dizziness 9 (0.8%), and others 5 (0.2%), respectively. Traditionally described needling sensations of de Qi refer to a patient's response to distention, pulling, soreness, heaviness, numbness. 39.7% of subjects reported de Qi during needling, experiencing 'distention' 333 (30.4%), 'soreness' 52 (4.7%), 'pulling' 22 (2.0%), 'heaviness' 18 (1.6%), and 'numbness' 10 (0.9%) respectively. Positive short term acupuncture reactions and de Qi rate were the highest in the less than 40 years group (83/96 86.5%, 50/96 52.1%). No acupuncture reactions were highly seen in the over 70 years old group (31/187, 16.6%). Patient satisfaction level using VAS was a comparatively high $72.9{\pm}19.9$. Adverse events were only bleeding in 92 (8.4%) of the total subjects. High sensitive acupoints were 95 points as GV26 (54 times), LI4 (54 times), ST36 (53 times), GB20 (37 times), HT8(34 times), LV3 (29 times), SI3 (29 times), and LI11 (27 times) in order. Main impressions were stroke patients 430 (16.9%), headache 185 (16.9%), hypertension 97 (8.9%), and dizziness 85 (7.8%). Conclusions : Although 8 different Korean Medicine Doctors participated in this research, we obtained similar results from each. There were no significantly different results between the two hospitals. Short term acupuncture reactions and de Qi were most related to age. Except for bleeding there were no adverse events relating to acupuncture treatment in this study. We consider acupuncture treatment as very safe depending on practitioners. Positive short term acupuncture reactions after treatment were 12 times higher than negative short term acupuncture reactions. Subjects were comparatively satisfied with acupuncture treatment.

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노인질환에 대한 한양방동시종합검진 결과에 대한 보고 (The Purpose and background of this study)

  • 권경숙;이태환;송정모;김인섭;윤호영;임준규
    • 대한한의학회지
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    • 제15권2호
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    • pp.9-27
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    • 1994
  • 연구(硏究)의 목적(目的) 및 배경(背景) : 본 연구는 노령인구의 증가와 더불어 심각한 사회문제화 되고 있는 노인병의 실태를 파악하기 위한 노인건강검진 사업의 일환으로 전주우석대부속한방병원 및 부설우석의원에서 국내최초의 한양방동시종합검진을 실시한 바 있어서, 이를 토대로 노인질환의 분포와 건강실태를 파악하고 한양방동시종합검진의 효율성을 검토해 보기 위함이다. 연구(硏究) 방법(方法) : 연구대상은 전라북도 김제군에 거주하는 60세 이상의 노인 641명을 대상으로 전주우석대부속한방병원 및 부설우석의원에서 1994.6.24부터 1994.7.13까지 실시한 한양방동시종합검진(1차 검진) 결과를 대상으로 하였다. 양방의 1차검진은 X-ray 검사, 혈액검사, 소변검사, 혈압, 시력, 청력 등의 측정으로 행해졌고, 한방검진은 한방의 사진법(四診法)(望,聞,問,切(망,문,문,절))과 현증력(現症歷), 주소증(主訴證), 과거력(過去歷), 가족력(家族歷), 사회력(社會歷) 등을 살피는 문진표(問診表)와 사상체질(四象體質) 테스트법을 이용하여 행해졌다. 결과(結果) 및 결론(結論) : 본 연구의 결과 및 결론은 다음과 같다. 1) 한양방종합판정상 검진 대상자 641명중 운동기계질환자 75.8%, 소화기계질환자 43.4%, 순환기계질환자 41.5%, 호흡기계질환자 22.3%, 안이비인후과질환자 8.1%, 내분비계질환자 5.6%, 비뇨생식기계질환자 5.3%의 순으로 질병을 앓고 있는 것으로 나타났다. 2) 병명에 따른 질환의 빈도를 살펴보면, 요통, 위염 및 소화성궤양, 슬통, 심장병, 고혈압, 만성기관지염, 기관지천식, 빈혈증, 당뇨병, 폐결핵, 시력장애, 중풍 등의 순으로 나타났다. 3) 연령별 질환의 빈도를 살펴보면, 60-75세, 76-85세, 86세 이상으로 구분할 때 대부분의 질환이 60-75세에 다발하는 경향을 보이고, 오히려 연령이 높아질수록 질병이환율이 감소하는 경향을 보이는 반면, 안이비인후과질환만이 점진적 증가를 보여 대조를 이루었다. 4) 가족력과 질환과의 상관관계를 살펴보면, 중풍환자의 25.0%가 중풍의 가족력을, 고혈압환자의 11.6%가 고혈압의 가족력을 가지고 있는 것으로 나타나 가족력과의 상관관계가 매우 높게 나타남을 알 수 있었고, 그밖에 결핵은 5.6%, 당뇨병은 2.6%가 가족력을 가지고 있는 것으로 나타났다. 5) 음주와 질환과의 상관관계를 살펴보면, 호흡기질환의 36.4%, 고혈압의 34.7%, 심장병의 33.3%, 소화기질환의 28.4%가 음주를 하는 것으로 나타났으나 음주의 정도는 조사되지 않아 음주와 질환과의 필연적 관계는 알 수 없었다. 6) 흡연과 질환과의 상관관계를 살펴보면, 호흡기질환의 44.1%, 심장병의 38.0%, 고혈압의 29.8%가 흡연을 하는 것으로 나타났으나 흡연의 정도는 조사되지 않아 흡연과 질환의 필연적 관계는 알 수 없었다. 7) 사상체질의 분포는 태음인(太陰人) 44.6%, 소양인(少陽人) 30.7%, 소음인(少陰人) 24.7%, 태양인(太陽人) 0.0%의 순으로 나타났고, 체질별 질환빈도는 모든 체질에서 운동기계 질환과 소화기계 질환의 이환율을 높았는데, 태음인에서는 순환기계질환(50.0%), 호흡기계질환 (23.1%)이 타체질에 비해 높게 나타났고, 소양인에서는 운동기계질환(77.7%), 난청등 안이비인후과 질환(12.2%)이 타체질에 비하여 높게 나타났고, 소음인에 있어서는 소화기계 질환(65.8%)이 타체질에 비해 높게 나타났다. 8) 양방의 1차검진상 이상소견자의 빈도와 한양방종합판정에 의한 질환의 빈도 사이에는 상당한 차이가 있는 것으로 나타났는데, 이는 노인질환의 특성상 건강검진에 한방의 참여가 필요한 이유가 되는 내용이라 사료된다. 이상에서 살펴본 바, 이번에 실시한 국내최초(國內最初)의 한양방동시종합검진(韓洋方同時綜合檢診)은 양방위주의 건강검진보다 노인의 질환과 건강실태를 파악하는데 있어서 훨씬 효율적(效率的)이었다고 사료되는 바이나, 처음 실시한 만큼 미진한 면이 많았다. 앞으로 한방이 공중보건사업에 효율적으로 차여하기 위해서는 많은 문제점을 개선하여 한양방동시종합검진의 모델과 한방보건사업의 프로젝트가 제시되어야 할 것으로 사료된다.

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한국에서의 벼 줄무늬잎마름병의 발생, 피해, 기주범위, 전염 및 방제에 관한 연구 (Studies on the Occurrence, Host Range, Transmission, and Control of Rice Stripe Disease in Korea)

  • 정봉조
    • 한국응용곤충학회지
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    • 제13권4호
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    • pp.181-204
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    • 1974
  • 우리나라에서의 벼 줄무늬잎마름병의 발생, 피해, 기생범위, 전염 및 방제에 관하여 1965년부터, 1974년까지 실시한 연구결과를 다음과 같이 보고한다. 1. 발생 못자리에서 줄무늬잎마름병의 피해는 $1.3-8\%$였고 포장에서는 입도중의 발병주율보다 재생도에서의 발생율이 높았으며 보통기재배보다도 조기재배에서 발병이 많았다. 또 포장에서 발병주의 분포는 대체로 휴반가까이에 많은 경향이었다. 벼 엽기별 피해에서 라병성인 일본계 벼의 경우 못자리 때인 3엽기에서 7엽기까지는 감염되면 $100\%$ 고사하였으며 9엽기에서는 $50\%$, 11엽기는 $20\%$, 13엽기 이후에는 고사주를 볼 수 없었다. 참복기간은 3-7엽기에서는 7-15일이었고 9-15엽기에서는 15-30일이었다. 저항성인 통일벼의 경우 1.5-5엽기 접종구는 비교적 발병이 많았으나 9엽기 이후부터는 현저히 떨어져 15엽기 이후는 발병을 거의 볼 수 없었다. 그리고 감염된 것은 초장이 짧고 등숙율과 임실비율이 떨어지는 경향이었다. 2. 기주범위 기주범위를 구명하기 위하여 작물과 목초 및 잡초 36종을 공시하여 아래와 같이 21종의 기주를 밝혀 내었다. 작물: 벼, 보리, 밀 , 귀리, 라이맥, 조, 옥수수, 기장, 참피 목초: 티모시, 빗살대, 이타리안라이그라스, 패래니 알라이그라스, 죤슨그라스, 슈단그라스 잡초 : 들피, 겨피, 방울피, 잠자리피, 개미피, 바랭이, 민바랭이, 좀바랭이, 방동사니대가리, 강아지풀, 비노리, 참새, 포아풀, 독새풀, 우산대바랭이, 개보리, 겨풀, 쇠풀, 조개풀, 넓은 잎 개수염은 새로운 기주로 밝혀졌다. 3. 충매전염 우리나라의 애멸구화기는 5회였으며 수원에서의 제2회성충 최성기는 6월 20일 경이고 제3회성충 최성기는 7월 30일 경이었다. 진주는 수원보다 제2회성충 최성기가 5-7일 빨랐고 진주에서는 제3회성충 최성기의 발생량이 많은 것이 달랐다. 애멸구 세대별 보독충율은 월동약충이 $10-15\%$였고 제1세대유충은 $9\%$, 제2회성충은 $17\%$, 제2세대유충은 $8\%$, 나머지 화기에서는 약 $10\%$였는데 보독충율은 남부지방보다 높은 경향이었다. 1966년부터 1970년생 사이의 애멸구 보독충율은 해에 따라 다소 차가 있었으며 화기별로는 제2회성충과 제3회성충의 보독충율이 높았다. 분리한 애멸구보독충을 재분리하여 이를 교배하였더니 차대에서는 보독충율이 $90\%$인 애멸구를 얻을 수 있었으며 애멸구충령별로는 3, 4, 5령충의 감염능력이 높았고 애멸구 무독충의 바이러스 재획득율은 평균$7.9\%$였고 여기에서 얻어진 친화성계통이라 할지라고 3회접종시험결과 계속하여 3회까지 벼에 바이러스를 매개하지 않았다. 또 애멸구보독충의 감염최적온도는 $25-30^{\circ}C$였으며, $15^{\circ}C$이하에는 감염이 일어나지 않을때도 있었다. 그리고 애멸구기생봉의 기생율은 6월부터 8월말까지 $5-48\%$였으며 7월 10일경이 $32-48\%$로서 가장 높았다.

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